fMRI of N-Back Task

Score Severity of
-Fatigue
PLUS
8 Ancillary Criteria
- Concentration or
memory problems
- Sleep disturbances
- Headache
- Sore throat
- Sore lymph nodes
- Muscle pain
- Joint pain
- Exertional exhaustion
Scale
0 = none
1 = trivial
2 = mild
3 = moderate
4 = severe
Sum of 8
CFS Severity Score (n=600)
- Sum8 correlates with Fatigue.
- Fatigue scores of 3 or 4 plus the threshold of 14 distinguishes
CFS from Chronic Idiopathic Fatigue (CIF), CFS-Like With
Insufficient Fatigue Syndrome (CFSLWIFS) and HC.
Pain and Tenderness:
Nociception, Systemic Hyperalgesia and Allodynia
• Mechanisms of central sensitization.
• Dorsal horn of the spinal cord.
• Primary synapse between peripheral pain-carrying Type C
neurons and ascending spinothalamic neurons.
• Long term loss of descending anti-nociceptive aminergic
nerve function (decreased norepinephrine, serotonin and
dopamine to dorsal horn) promotes more pain input.
• Loss of norepinephrine release that ascends from the
brainstem locus coeruleus to the cortex:
– This system regulates acute responses to stressors by altering
analysis of sensory and interoceptive inputs, focus of attention,
mood (fear) and “efferent” autonomic, neuroendocrine, and
executive decision making processes. The neural connections
are related to the “default mode pathway” that is active during
rest.
2/6/2012
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